Policy Corner: June 4, 2021

President Releases Budget Recommendations

The White House released President Biden’s budget recommendations for fiscal year (FY) 2022 federal programs. Overall, the budget provides additional funding for the U.S. Department of Health and Human Services (HHS) to address the COVID-19 pandemic, health care, issues relating to unaccompanied migrant children, climate change, the opioid and substance use crisis, and violence to the tune of $131.8 billion in discretionary budget authority and $1.5 trillion in mandatory funding. The budget builds on the reforms included in the American Rescue Plan Act by extending the premium subsidies for health care coverage and includes funding to address child care, including early child education programs, and funding to address the public health crises of mental health and substance use. The following is a summary of recommendations for HHS programs impacting individuals with brain injury and their families:

Administration for Community Living

With regard to the Administration for Community Living (ACL), the president’s budget requests a program level of $3.1 billion, an increase of $768 million above FY 2021, primarily for programs that provide direct services that support older adults and people with disabilities to live in the community; improving support to caregivers; and advancing equity in all of ACL programs. The budget provides $12 million for the Traumatic Brain Injury (TBI) program, authorized by the TBI Program Reauthorization Act of 2018, which provides grants to protection and advocacy in each state and territory; and competitive grants to state government for purposes of developing comprehensive, coordinated family and person-centered service systems at the state and community level. This represents a $1 million increase over the FY 2021 funding.

The budget also proposes a $6 million increase for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) program, of which increased funding will allow NIDILRR to increase the number of grants made through its field-initiated grant competitions and will fund three new Rehabilitation Research and Training Centers – one in each of three outcome domains: community living and participation, employment, and health and function. Each of these centers will conduct research to support the development and testing of practices, policies, services, or supports to address the disparate outcomes experienced by people with disabilities from populations that have been historically underserved or marginalized. The total funding recommended is $119 million.

Centers for Disease Control and Prevention, National Injury Center

The president’s budget requests more than $1.1 billion in discretionary spending, an increase of more than $420 million over the 2021 enacted budget, for the National Center on Injury Prevention and Control. There are no proposed reductions to any current funding lines. The FY 2022 budget includes funding to reduce all forms of violence, including community violence, gun violence, intimate partner violence, gender-based violence, and sexual violence. The budget includes a total of $25 million, to support firearm injury and mortality prevention research and data collection to identify the most effective ways to prevent firearm-related injuries and deaths.

The budget does not include $5 million for a national concussion surveillance system authorized by the TBI Program Reauthorization Act of 2018 that the Brain Injury Association of America, Congressional Brain Injury Task Force, National Association of State Head Injury Administrators, and other organizations are recommending.

National Institutes of Health

The FY 2022 President’s budget includes $52 billion for the National Institutes of Health (NIH), an increase of $9 billion above FY 2021 enacted. Of the $9 billion increase, $6.5 billion is to support the establishment of the Advanced Research Projects Agency for Health, a new entity within NIH that will speed transformational innovation in health research. The remaining $2.5 billion is to continue investing in basic research and translating it into clinical practice to address the most urgent challenges, which include ending the opioids crisis, climate change, and gun violence. The president’s budget doubles funding within NIH to $25 million for firearm violence prevention research to improve understanding of the determinants of firearm injury, the identification of those at risk of firearm injury (including both victims and perpetrators), the development and evaluation of innovative interventions to prevent firearm injury and mortality, and the examination of approaches to improve the implementation of existing, evidence-based interventions to prevent firearm injury and mortality. The president is also recommending an additional $272 million for the National Institute of Neurological Disorders and Stroke, which is the lead center in conducting brain injury research.

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action. Click here to read past issues of Policy Corner.